Individual provider Active NPI

Joel Riordan, PT, DPT

  • Physical Therapist
  • Windom, MN
National Provider Identifier
1548029291
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11775 Issued in MN
Practice address
2150 Hospital Dr
Windom, MN 56101-1287
Phone
(507) 831-0634
NPI assigned
Mar 15, 2024
Last updated
Mar 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11775 MN Primary

Addresses

Primary practice location

2150 Hospital Dr
Windom, MN 56101-1287

Mailing address

805 17TH St
Windom, MN 56101-1124
Phone (507) 822-6663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11775MNMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1710460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1548029291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 17TH ST",
            "city": "WINDOM",
            "state": "MN",
            "postal_code": "561011124",
            "telephone_number": "507-822-6663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 HOSPITAL DR",
            "city": "WINDOM",
            "state": "MN",
            "postal_code": "561011287",
            "telephone_number": "507-831-0634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIORDAN",
        "first_name": "JOEL",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-15",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "11775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windom, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.